# Improving Stuttering Through Augmented Multisensory Feedback Stimulation

## TL;DR

A new therapy called AMFS helps people who stutter by using multisensory feedback to improve speech fluency and reduce physiological stress.

## Contribution

AMFS is a novel personalized intervention combining neurocomputational modeling with dynamic multisensory stimulation to treat stuttering.

## Key findings

- Stuttering severity significantly decreased after the intensive AMFS phase and remained reduced during reinforcement.
- Physiological activity like heart rate and muscle activity decreased during training in people who stutter.
- Post-intervention, people who stutter performed similarly to non-stuttering controls in speech tasks.

## Abstract

Background/Objectives: Stuttering is a speech disorder involving fluency disruptions like repetitions, prolongations, and blockages, often leading to emotional distress and social withdrawal. Here, we present Augmented Multisensory Feedback Stimulation (AMFS), a novel personalized intervention to improve speech fluency in people who stutter (PWS). AMFS includes a five-day intensive phase aiming at acquiring new skills, plus a reinforcement phase designed to facilitate the transfer of these skills across different contexts and their automatization into effortless behaviors. The concept of our intervention derives from the prediction of the neurocomputational model Directions into Velocities of Articulators (DIVA). The treatment applies dynamic multisensory stimulation to disrupt PWS’ maladaptive over-reliance on sensory feedback mechanisms, promoting the emergence of participants’ natural voices. Methods: Forty-six PWS and a control group, including twenty-four non-stuttering individuals, participated in this study. Stuttering severity and physiological measures, such as heart rate and electromyographic activity, were recorded before and after the intensive phase and during the reinforcement stage in the PWS but only once in the controls. Results: The results showed a significant reduction in stuttering severity at the end of the intensive phase, which was maintained during the reinforcement training. Crucially, worse performance was found in PWS than in the controls at baseline but not after the intervention. In the PWS, physiological signals showed a reduction in activity during the training phases compared to baseline. Conclusions: Our findings show that AMFS provides a promising approach to enhancing speech fluency. Future studies should clarify the mechanisms underlying such intervention and assess whether effects persist after the treatment conclusion.